F101: Greatest Cases from the Dermatopathology Slide Club

In a presentation on noteworthy cases from the Dermatopathology Slide Club, Dr. Paulek Barrick from Baylor Scott and White discussed several intriguing dermatological cases. The first case involved a 78-year-old man with a six-year history of a pruritic rash who was treated with dupilumab. Initially, he experienced improvement, but later developed worsening symptoms and annular erosions, leading to further biopsies which suggested a possible drug eruption. Despite discontinuing dupilumab, the patient’s condition worsened, eventually leading to a diagnosis of aggressive CD8 positive cytotoxic lymphoma. The case emphasized the need to recognize specific histological features and the importance of clinical presentation in diagnosis. The second case presented a 72-year-old man with persistent lower extremity ulcers linked to a previous vascular procedure. Initial treatments failed, but subsequent biopsies revealed hydrophilic polymer gel emboli resulting from endovascular device usage, highlighting the need for awareness of unusual complications in patients with vascular disease. Lastly, a 55-year-old woman with erythematous patches on her leg, initially deemed idiopathic, was later diagnosed with acrodermatitis chronica atrophicans when Lyme titers tested positive, demonstrating the challenge of diagnosing conditions that may not present with clear histories or typical symptoms. Collectively, these cases underscored the complexities of dermatology and the critical role of thorough clinical investigation.